Sunday, May 26, 2019

End of Life Care: Family Health Essay

In nursing, the goal of worry is usually to restore the patient back to the highest aim of health possible. In some cases, however, the goals of c be change when a curative approach is no longer appropriate. The new goals of care could simply be extenuation and painful sensation control rather than a restoration back to honorable health. This type of care is called palliative care. Palliative care is not the same as end-of-life care, but the two go hand-in-hand at times. The goal of end-of-life care is a legal remainder, nigh being defined by the patient. Palliation is part of that good death. Both palliative care and end-of-life care are realms of patient care that tail end be highly sensitive for those involved. A take in must be able to navigate these waters carefully. The physically and mentally exhaustive nature of illness and dying takes a huge toll on the patient and his/her family. Anyone pot qualify for palliative or end-of-life care regardless of race, gender, ag e, or any other demographic factors. It simply depends on the disease-state, the recommendations of the health care providers, and the goals of the patient.It is estimated that 69%-82% of those who travel in high income countries such as the United States get out need palliative care (Murtagh, Bausewein, Verne, Groeneveld, Kaloki, & Higginson, 2013), illustrating the need for curbs to familiarize themselves with this type of care. star concern diffuse by many nurses is a not knowing what to do or say during end-of-life care (Sherwen, 2014). In the case of cancer, in particular, which has become more of a long-term illness, nurses feel uncomfortable and may miss opportunities in patient care (Sherwen, 2014). The following go out be a discussion of palliative/end-of-life care and what the nurse can do to help the family and patient during a difficult time. A successful case is one in which the patient and his/her family feel stand out and listened to throughout the whole proces s and the goals of the patient are achieved. DiscussionWhen does palliative care begin? When does end-of-life care begin? These are questions that can only be answered by the individualist going through the disease process and the team of caregivers advising him/her. A simple answer to both questions would be this when the goals of care change from full restoration to health to comfort, relief of symptoms, and maintaining as high a quality of life as possible given the disease-state. Palliative care has a broader rendering in that it focuses mainly on the patients comfort and can be applied to many other cases besides the imminently dying patient. The first development of palliative care was primarily for patients with cancer, in which there may not be a cure, but symptom management and prevention of emanation of the disease is the primary goal (Kaakinen, Coehlo, Steele, Tabacco, & Hanson, 2015, p. 278).It has since branched out to other illnesses with poor prognosis but long di sease-course it really depends on the care team and the individual as to when it is implemented. End-of-life care, on the other hand, is a series of decisions made by the family when death is imminent (projected in the next days to months). They must decide how some(prenominal) medical intervention they want done with their family member, where the ideal death would occur (in their home vs. in a facility), and what their definition of a good death would be. both case is different and there is not always time to plan everything, but this is a general outline.Before approaching any new area of nursing, a nurse must assess his/her own personal beliefs and for the presence of any biases about death and illness. It may be that the nurse has never encountered death and dying face-to-face and may hold pre-conceived notions that may not be in harmony with the patients beliefs. Identifying these biases and correcting them is crucial to taking care of the patient. small-arm it is not wise or possible to separate ones own person from one person as a nurse, it is better to pick up ways to help the patient through the process without burdening them with your own beliefs.Dying is a process that involves the entire family that is to say, the family that is defined by the person. The nurse must be aware that this isnot only an individual process but a family process. This involves recognizing family dynamics and communication patterns and facilitating healthy interactions.Kaakinen et al (2015) discusses the two types of health care teams that will be involved in the patients care multiprofessional and interprofessional. The multiprofessional model is an older model that does not focus on holistic care. Care is garbled with an autocratic leader, vertical communication, separate goals of the professionals involved, and families are peripheral to the process (Kaakinen et al., 2015). The preferred model is the interprofessional model emphasizing a team approach, holistic car e of the patient, even communication, and involvement of the family (Kaakinen et al., 2015). The nurse should keep this collaborative approach in mind when dealing with any patient case, involving all teams associated with the patient for the best outcome.It is important to immortalize that care of the patient does not end when the patient dies. After the death there is still work to be done in the form of solace the bereaved family members. It has been reported that some families feel abandoned after the death of a loved one by the hospital staff and this simply should not be so (Kaakinen et al., 2015). The nurses role after death involves simply a comforting presence, providing resources, answering questions, and listening to concerns. It may also be helpful to give the family information about what to expect next, what information is needed from them (funeral home arrangements, organ donation, etc.), and provide a place for them to rest and process.The relationship the nurse h as with the patient is integral to positive patient outcomes. Ways that a nurse can improve this relationship include being professional, being sensitive, listening, and establishing trust. The nurse ask to be able to communicate and be communicated with clearly and easily. This will be a challenge for some families who already begin poor communication skills. intercommunicate questions and taking time to listen go a long way in opening up communication.It is of benefit to the nurse to try and center his/her idea on what the dying patients goals are. A dying person wants to feel some semblance of control, strengthen personal relationships, and be relieved of pain and suffering. Good end-of-life care involves finding these goals, describing to the patient what good end-of-life care might look like, talk about symptoms that may occur, and discuss the importance of good communication, good relationships, and the role of informal (family) caregivers (Sherwen, 2014, p. 51).When palli ative care and end-of-life care are the direction care is taking, the nurse needs to shift gears in a positive way. One positive step the nurse can take is to empower the family during this time. Many families feel helpless against the diagnosis, but the nurse can show them that they still have an element of control. The nurse should provide them with information about the disease process, give the family resources in the community for support and services, and most of all offer encouragement. There will be negative feelings present in most cases, including feelings of hopelessness, depression, anxiety, and loss of control. The nurse must recognize these negative feelings and start a conversation. The nurse needs to be a facilitator of conversation between family members in order to identify common goals. Family meetings are a great tool to utilize throughout. It is held between caregivers and leaders in the family and can reveal concerns, answer questions, and establish goals of ca re.Parts of positively dealing with a dying loved one include balancing hope and preparing for death, as well as finding meaning in the situation (Kaakinen et al., 2015). These are things that may be beyond the scope of the nurses practice, but identifying them is important. The nurse can bring in social work, the palliative care team, and pastoral care to assist the family whatever is appropriate.When the time comes for the actual death of the patient, there are clinical signs and symptoms that the nurse must recognize. Care at the time of active dying is crucial for a good death. Some symptoms such as sleeping, change magnitude hydration and food needs may be easy for the family to offer, butothers, such as restlessness, difficulty breathing, and confusion may be very difficult to bear (Kaakinen et al., 2015). The nurse and care team must work together to provide maximum comfort for the patient as well as emotional support for the family during this difficult time. ConclusionIn conclusion, there is a point in a patients care where the focus shifts from curative to palliative, often in the case of cancers but in some other cases as well. The nurse needs to familiarize his/herself with this topic in order to provide optimal care. He/she must assess his/her beliefs and biases on the topic and address those that may be a source of conflict. The goals of the patient and his/her family must be established. Family meetings and conversations need to occur to drive communication, address concerns, and provide information. The nurse plays an important role in providing information for the family, managing negative feelings, encouraging hope, and preparing for the death. At the end-of-life and after the actual death the nurse can provide compassionate care, display sensitivity, and comfort the bereaved.Death is the inevitable outcome of this life that all must face and a nurse has a finical opportunity to help a family through the process. Helping and comforting a family during this process can be a truly rewarding aspect of a nurses career.ReferenceKaakinen, J., Coehlo, D., Steele, R., Tabacco, A., Hanson, S. (2015). Family Health Care Nursing Theory, Practice, and question. (5th ed.). Philadelphia PA F.A. Davis Company Murtagh, F., Bausewein, C., Verne, J., Groeneveld, E., Kaloki, Y., & Higginson, I. (2013). How many people need palliative care? A occupy developing and comparing methods for population-based estimates. Palliative Medicine. 28(1). 49-58. Doi10.1177/0269216313489367 ***Sherwen, E. (2014). Improving end of life care for adults. Nursing Standard, 28(32), 51-57. Trueland, J. (2014). All it takes is a bit of specialist knowledge. Nursing Standard, 29(3), 26-27. ***Research Article

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